Q: I am a 67-year-old man and I have had pain in the heel of my left foot for the past four or five months.

I feel a severe pain every morning when I wake up and put my feet on the floor. The pain slowly goes away once I get up and start walking. It also comes on when I stand up to walk after I've been sitting for some time.

I've tried applying 'Fastum' cream but to no avail.

Can you tell me what the problem is and what treatments are available?

A: You are probably suffering from plantar fascitis, a form of localised inflammation of the plantar fascia where it is attached to the heel bone, or calcaneum.

The plantar fascia is a very strong, dense and fibrous membrane of the sole of the foot that lies beneath the skin and superficial layer of fat. It binds the deeper structures and maintains the shape of the foot.

The common treatment for this is physiotherapy. If this fails, a steroid or local anaesthetic injection will offer relief. Other treatment options are laser treatment (extracorporeal shock wave therapy) and surgery, which is the last option.

Dr Sittampalam Krishnamoorthy

- Dr Sittampalam Krishnamoorthy is a consultant orthopaedic surgeon at Raffles Hospital.

This story was first published in Mind Your Body, The Straits Times, on Sept 4, 2008.

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